Presentation
Abstract Macroprolactinomas rarely present with apoplexy. The authors describe a patient with a macroprolactinoma who presented with apoplexy and rapid progression of a third nerve palsy. [ncbi.nlm.nih.gov]
Entire Body System
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Chest Discomfort
Three and a half hours after bromocriptine administration, he suddenly complained of anterior chest discomfort in bed. Cyanosis and profuse diaphoresis were noted. His blood pressure was 80/60 mmHg. [ncbi.nlm.nih.gov]
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Cushingoid
A 73-year-old woman presented with disturbance of right eyelid opening with ptosis and impairment of right ocular movement, and later was found to have Cushingoid features. [ncbi.nlm.nih.gov]
Gastrointestinal
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Nausea
The most common adverse effect of bromocriptine-QR was nausea reported by 32% of patients compared with 7% of patients randomized to placebo. [ncbi.nlm.nih.gov]
Most frequent side effects are nausea, orthostatic hypotension, headaches, and vomiting through stimulation of the brainstem vomiting centre. [en.wikipedia.org]
Check with your doctor right away if you develop blurred vision, a sudden headache, or severe nausea and vomiting. Bromocriptine may cause some people to become drowsy, dizzy, or less alert than they are normally. [drugs.com]
• If desired, give at bedtime to minimize dizziness and nausea. • For Cycloset, administer within 2 hours of patient's waking in the morning and with food. [medical-dictionary.thefreedictionary.com]
Cardiovascular
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Orthostatic Hypotension
Most frequent side effects are nausea, orthostatic hypotension, headaches, and vomiting through stimulation of the brainstem vomiting centre. [en.wikipedia.org]
Adverse effects Orthostatic hypotension, vomiting, vertigo, headaches, upset stomach, coronary vasospasm, pulmonary fibrosis, hepatotoxicity. [medical-dictionary.thefreedictionary.com]
INDICATIONS: SIDE-EFFECTS AND SPECIAL PRECAUTIONS: SIDE-EFFECTS Nausea, dizziness, vomiting and orthostatic hypotension are frequently experienced during the first few days of treatment, but should not be serious enough to warrant discontinuation of treatment [home.intekom.com]
Adverse Reactions Cardiovascular Postural / orthostatic hypotension, syncope ,cardiac valvulopathy, hypertension, MI, stroke CNS Headache, dizziness, fatigue, light - headedness, somnolence ,drowsiness ,confusion, hallucinations, psychomotor agitation [slideshare.net]
Domperidone for Drug-Induced Orthostatic Hypotension – A Review. Jefferson J Psychiatry 2011; 10: 5 41 Senard JM, Rai S, Lapeyre-Mestre M, Brefel C, Rascol O, Rascol A, Montastruc JL. Prevalence of orthostatic hypotension in Parkinson’s disease. [doi.org]
Skin
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Alopecia
[…] vomiting, diarrhea, constipation, abdominal cramps, anorexia, dry mouth, GI hemorrhage GU: urinary incontinence, polyuria, urinary retention Musculoskeletal: leg cramps Skin: urticaria, coolness and pallor of fingers and toes, rash on face and arms, alopecia [medical-dictionary.thefreedictionary.com]
Early / 4.0-4.0 dizziness / Early / 0-2.0 syncope / Early / 0-2.0 insomnia / Early / 0-1.0 paranoia / Early / 0-1.0 vertigo / Early / 0-1.0 muscle cramps / Delayed / 0-1.0 paresthesias / Delayed / 0-1.0 pallor / Early / 0-1.0 rhinorrhea / Early / 0-1.0 alopecia [pdr.net]
Psychiatrical
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Increased Libido
libido (BNF 2016) Occasionally these drugs can cause more serious side-effects, which you should be monitored for (BNF 2016). [babycentre.co.uk]
Urogenital
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Urinary Incontinence
• Genitourinary : Urinary frequency, urinary incontinence, urinary retention and increased Blood Urea Nitrogen. Avoid alcohol consumption. Use proper contraception methods to prevent pregnancy while taking this medication. [medindia.net]
incontinence, polyuria, urinary retention Musculoskeletal: leg cramps Skin: urticaria, coolness and pallor of fingers and toes, rash on face and arms, alopecia Other: metallic taste, digital vasospasm (in acromegaly use only), infection Interactions [medical-dictionary.thefreedictionary.com]
anxiety, blepharospasm, dry mouth, dysphagia, edema of the feet and ankles, erythromelalgia, epileptiform seizure, fatigue, headache, lethargy, mottling of skin, nasal stuffiness, nervousness, nightmares, paresthesia, skin rash, urinary frequency, urinary [reference.medscape.com]
Neurologic
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Headache
One patient, previously normotensive, developed hypertension and a headache; initial CT was normal, but CT 24 h later demonstrated intracranial hemorrhage. [ncbi.nlm.nih.gov]
Migraine Headache Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on... [medicinenet.com]
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Vertigo
Adverse effects Orthostatic hypotension, vomiting, vertigo, headaches, upset stomach, coronary vasospasm, pulmonary fibrosis, hepatotoxicity. [medical-dictionary.thefreedictionary.com]
CNS: Headache, dizziness, vertigo, light-headedness, fainting, sedation, nightmares, insomnia, dyskinesia, ataxia; mania, nervousness, anxiety, depression. [robholland.com]
Rarely (less than 1%) hair loss, alcohol potentiation, faintness, lightheadedness, arrhythmia, ventricular tachycardia, decreased sleep requirement, visual hallucinations, lassitude, shortness of breath, bradycardia, vertigo, paresthesia, sluggishness [drugs.com]
[…] involuntary movements, hallucinations, confusion, “on-off’’ phenomenon, dizziness, drowsiness, faintness/fainting, vomiting, asthenia, abdominal discomfort, visual disturbance, ataxia, insomnia, depression, hypotension, shortness of breath, constipation, and vertigo [reference.medscape.com]
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Aphasia
By means of aphasia tests, bromocriptine was found to be ineffective for the treatment of any symptoms of chronic nonfluent aphasia. [ncbi.nlm.nih.gov]
Published interaction reports between intravenously administered methylene blue and serotonergic psychiatric agents have documented symptoms including lethargy, confusion, delirium, agitation, aggression, obtundation, myoclonus, expressive aphasia, hypertonia [pdr.net]
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Paresthesia
Symptoms of ergotism include angina, asthenia, chest pain (unspecified), coronary vasospasm, muscle cramps (claudication), myalgia, paresthesias, and palpitations or changes in heart rate (e.g., sinus bradycardia or sinus tachycardia). [pdr.net]
Rarely (less than 1%) hair loss, alcohol potentiation, faintness, lightheadedness, arrhythmia, ventricular tachycardia, decreased sleep requirement, visual hallucinations, lassitude, shortness of breath, bradycardia, vertigo, paresthesia, sluggishness [drugs.com]
[…] constipation, and vertigo Less common: Anorexia, anxiety, blepharospasm, dry mouth, dysphagia, edema of the feet and ankles, erythromelalgia, epileptiform seizure, fatigue, headache, lethargy, mottling of skin, nasal stuffiness, nervousness, nightmares, paresthesia [reference.medscape.com]
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Neglect
Bromocriptine produced more improvement in neglect than methylphenidate. Although the patient showed an exacerbation of his neglect after withdrawal from methylphenidate, performance gains persisted after withdrawal from bromocriptine. [ncbi.nlm.nih.gov]
Workup
X-Ray
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Pericardial Effusion
Within 3 days since delivery she suffered from severe symptoms of heart failure (orthopnoea, pleural and pericardial effusion, reduced systolic function LVEF 15%). [ncbi.nlm.nih.gov]
Metabolic Hypoglycemia Respiratory Constrictive pericarditis, pleural and pericardial effusion, pleural and pulmonary fibrosis, pleural thickening GI Nausea, constipation, diarrhea ,dyspepsia, vomiting anorexia ,abdominal cramps, GI bleeding 11. [slideshare.net]
effusions) Psychotic and psychiatric disorders Stroke Neuroleptic-like malignant syndrome Parlodel Psychiatric disorders: Confusion, psychomotor agitation/excitation, hallucinations, psychotic disorders, insomnia, libido increase, hypersexuality Nervous [reference.medscape.com]
Heart attack, history of or Heart or blood vessel disease (eg, pericardial effusion) or Hypertension (high blood pressure) or Lung disease (eg, pleural effusion, pulmonary fibrosis) or Mental illness (eg, psychosis), history of or Retroperitoneal fibrosis [drugs.com]
Serum
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Prolactin Decreased
Moriondo P et al. (1985) Bromocriptine treatment of microprolactinomas: evidence of stable prolactin decrease after drug withdrawal. J Clin Endocrinol Metab 60 : 764–772 36. [nature.com]
Treatment
The authors have found that bromocriptine treatment during pregnancy significantly reduces the embryo stop rate without in- creasing the embryo deformity rate; therefore, bromocriptine treatment is safe and necessary during pregnancy of pituitary prolactinoma [ncbi.nlm.nih.gov]
Prognosis
Balancing the potential side effects of bromocriptine against the very poor prognosis in severe PPCM our case supports the use of bromocriptine as a specific novel therapy. [ncbi.nlm.nih.gov]
Therefore strategies are urgently needed to identify patients at risk and novel therapeutic approaches are required to improve poor prognosis of affected women. [clinicaltrials.gov]
The severity and prognosis of DAWS is highly variable. [doi.org]
Predictors of prognosis in patients with peripartum cardiomyopathy. Int Gynaecol Obstet. 2008 ; 101 : 137–140. Crossref Medline Google Scholar 21 Chapa JB, Heiberger HB, Weinert L, DeCara J, Lang RM, Hibbard JU. [ahajournals.org]
Etiology
Peripartum cardiomyopathy (PPCM) is a serious life threatening heart disease of unknown etiology in previously healthy women. [clinicaltrials.gov]
This poster describes the neurobiology of Schizophrenia, as well as highlighting the genetic and environmental factors that play a fundamental role in the etiology of the disease. The current and emerging drug targets are also discussed. [tocris.com]
Current understanding of the epidemiology, etiology, clinical profile, and management of PPCM. Lancet. 2006 ; 368 : 687–693. Crossref Medline Google Scholar 2 Elkayam U, Akhter MW, Singh H, Khan S, Bitar M, Hameed A, Shotan A. [ahajournals.org]
A symptom complex resembling the neuroleptic malignant syndrome (characterized by elevated temperature, muscular rigidity, altered consciousness, and autonomic instability), with no other obvious etiology, has been reported in association with rapid dose [drugs.com]
Epidemiology
Working Group on Epidemiology and Prevention of Cardiovascular Diseases: Meeting of the Working Group of the European Society of Cardiology on Epidemiology and Prevention of Cardiovascular Diseases 9,Suppl. 1 von: Weltgesundheitsorganisation. [zdb-katalog.de]
National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2· 7 million participants. [doi.org]
Current understanding of the epidemiology, etiology, clinical profile, and management of PPCM. Lancet. 2006 ; 368 : 687–693. Crossref Medline Google Scholar 2 Elkayam U, Akhter MW, Singh H, Khan S, Bitar M, Hameed A, Shotan A. [ahajournals.org]
Epidemiology. 1990; 1:232-8. 108. Eickman FM. Recurrent myocardial infarction in a postpartum patient receiving bromocriptine. Clin Cardiol. 1992; 15:781-3. 109. Gittelman D. [drugs.com]
Pathophysiology
Here, we highlight the current state of knowledge on diagnosis of PPCM, provide insights into the biology and pathophysiology of 16-kDa PRL and bromocriptine, and outline potential consequences for the clinical management and treatment options for PPCM [ncbi.nlm.nih.gov]
Lieberman, Molecular pathophysiology of metabolic effects of antipsychotic medications, Trends in Endocrinology & Metabolism, 25, 11, (593), (2014). [doi.org]
Prevention
As a result, bromocriptine prevents the secretion of prolactin, thereby preventing or suppressing milk production. [ema.europa.eu]
[…] positive effects with respect to prevention or treatment of PPCM patients. [ncbi.nlm.nih.gov]